
<form name="editForm" role="form" novalidate ng-submit="vm.save()">

    <div class="modal-header">
        <button type="button" class="close" data-dismiss="modal" aria-hidden="true"
                ng-click="vm.clear()">&times;</button>
        <h4 class="modal-title" id="myProtectScopeLabel" data-translate="byibserverApp.protectScope.home.createOrEditLabel">Create or edit a Protect Scope</h4>
    </div>
    <div class="modal-body">
        <jhi-alert-error></jhi-alert-error>
        <div class="form-group" ng-show="vm.protectScope.id">
            <label for="id" data-translate="global.field.id">ID</label>
            <input type="text" class="form-control" id="id" name="id"
                    ng-model="vm.protectScope.id" readonly />
        </div>
        <div class="form-group">
            <label class="control-label" data-translate="byibserverApp.protectScope.strichenNumScore" for="field_strichenNumScore">Strichen Num Score</label>
            <input type="text" class="form-control" name="strichenNumScore" id="field_strichenNumScore"
                    ng-model="vm.protectScope.strichenNumScore"
                    />
        </div>
        <div class="form-group">
            <label class="control-label" data-translate="byibserverApp.protectScope.sicknessDefinitionScore" for="field_sicknessDefinitionScore">Sickness Definition Score</label>
            <input type="text" class="form-control" name="sicknessDefinitionScore" id="field_sicknessDefinitionScore"
                    ng-model="vm.protectScope.sicknessDefinitionScore"
                    />
        </div>
        <div class="form-group">
            <label class="control-label" data-translate="byibserverApp.protectScope.strichenClaimTimesScore" for="field_strichenClaimTimesScore">Strichen Claim Times Score</label>
            <input type="text" class="form-control" name="strichenClaimTimesScore" id="field_strichenClaimTimesScore"
                    ng-model="vm.protectScope.strichenClaimTimesScore"
                    />
        </div>
        <div class="form-group">
            <label class="control-label" data-translate="byibserverApp.protectScope.diescore" for="field_diescore">Diescore</label>
            <input type="text" class="form-control" name="diescore" id="field_diescore"
                    ng-model="vm.protectScope.diescore"
                    />
        </div>
        <div class="form-group">
            <label class="control-label" data-translate="byibserverApp.protectScope.mildCaseNumScore" for="field_mildCaseNumScore">Mild Case Num Score</label>
            <input type="text" class="form-control" name="mildCaseNumScore" id="field_mildCaseNumScore"
                    ng-model="vm.protectScope.mildCaseNumScore"
                    />
        </div>
        <div class="form-group">
            <label class="control-label" data-translate="byibserverApp.protectScope.mildDefinitionScore" for="field_mildDefinitionScore">Mild Definition Score</label>
            <input type="text" class="form-control" name="mildDefinitionScore" id="field_mildDefinitionScore"
                    ng-model="vm.protectScope.mildDefinitionScore"
                    />
        </div>
        <div class="form-group">
            <label class="control-label" data-translate="byibserverApp.protectScope.mildClaimTimesScore" for="field_mildClaimTimesScore">Mild Claim Times Score</label>
            <input type="text" class="form-control" name="mildClaimTimesScore" id="field_mildClaimTimesScore"
                    ng-model="vm.protectScope.mildClaimTimesScore"
                    />
        </div>
        <div class="form-group">
            <label class="control-label" data-translate="byibserverApp.protectScope.otherProtectRemitText" for="field_otherProtectRemitText">Other Protect Remit Text</label>
            <input type="text" class="form-control" name="otherProtectRemitText" id="field_otherProtectRemitText"
                    ng-model="vm.protectScope.otherProtectRemitText"
                    />
        </div>
        <div class="form-group">
            <label class="control-label" data-translate="byibserverApp.protectScope.otherProtectRemitScore" for="field_otherProtectRemitScore">Other Protect Remit Score</label>
            <input type="text" class="form-control" name="otherProtectRemitScore" id="field_otherProtectRemitScore"
                    ng-model="vm.protectScope.otherProtectRemitScore"
                    />
        </div>
        <div class="form-group">
            <label class="control-label" data-translate="byibserverApp.protectScope.otherProtectRestoreText" for="field_otherProtectRestoreText">Other Protect Restore Text</label>
            <input type="text" class="form-control" name="otherProtectRestoreText" id="field_otherProtectRestoreText"
                    ng-model="vm.protectScope.otherProtectRestoreText"
                    />
        </div>
        <div class="form-group">
            <label class="control-label" data-translate="byibserverApp.protectScope.otherProtectRestoreScore" for="field_otherProtectRestoreScore">Other Protect Restore Score</label>
            <input type="text" class="form-control" name="otherProtectRestoreScore" id="field_otherProtectRestoreScore"
                    ng-model="vm.protectScope.otherProtectRestoreScore"
                    />
        </div>
        <div class="form-group">
            <label class="control-label" data-translate="byibserverApp.protectScope.otherProtectHongeText" for="field_otherProtectHongeText">Other Protect Honge Text</label>
            <input type="text" class="form-control" name="otherProtectHongeText" id="field_otherProtectHongeText"
                    ng-model="vm.protectScope.otherProtectHongeText"
                    />
        </div>
        <div class="form-group">
            <label class="control-label" data-translate="byibserverApp.protectScope.otherProtectHongScore" for="field_otherProtectHongScore">Other Protect Hong Score</label>
            <input type="text" class="form-control" name="otherProtectHongScore" id="field_otherProtectHongScore"
                    ng-model="vm.protectScope.otherProtectHongScore"
                    />
        </div>
        <div class="form-group">
            <label class="control-label" data-translate="byibserverApp.protectScope.otherProtectGreenText" for="field_otherProtectGreenText">Other Protect Green Text</label>
            <input type="text" class="form-control" name="otherProtectGreenText" id="field_otherProtectGreenText"
                    ng-model="vm.protectScope.otherProtectGreenText"
                    />
        </div>
        <div class="form-group">
            <label class="control-label" data-translate="byibserverApp.protectScope.otherProtectGreenScore" for="field_otherProtectGreenScore">Other Protect Green Score</label>
            <input type="text" class="form-control" name="otherProtectGreenScore" id="field_otherProtectGreenScore"
                    ng-model="vm.protectScope.otherProtectGreenScore"
                    />
        </div>
        <div class="form-group">
            <label class="control-label" data-translate="byibserverApp.protectScope.claimFitnessScore" for="field_claimFitnessScore">Claim Fitness Score</label>
            <input type="text" class="form-control" name="claimFitnessScore" id="field_claimFitnessScore"
                    ng-model="vm.protectScope.claimFitnessScore"
                    />
        </div>
        <div class="form-group">
            <label class="control-label" data-translate="byibserverApp.protectScope.claimSpeedScore" for="field_claimSpeedScore">Claim Speed Score</label>
            <input type="text" class="form-control" name="claimSpeedScore" id="field_claimSpeedScore"
                    ng-model="vm.protectScope.claimSpeedScore"
                    />
        </div>

        <div class="form-group">
            <label data-translate="byibserverApp.protectScope.product" for="field_product">Product</label>
            <select class="form-control" id="field_product" name="product" ng-model="vm.protectScope.productId" ng-options="product.id as product.id for product in vm.products"            >
                <option value=""></option>
            </select>
        </div>
    </div>
    <div class="modal-footer">
        <button type="button" class="btn btn-default" data-dismiss="modal" ng-click="vm.clear()">
            <span class="glyphicon glyphicon-ban-circle"></span>&nbsp;<span data-translate="entity.action.cancel">Cancel</span>
        </button>
        <button type="submit" ng-disabled="editForm.$invalid || vm.isSaving" class="btn btn-primary">
            <span class="glyphicon glyphicon-save"></span>&nbsp;<span data-translate="entity.action.save">Save</span>
        </button>
    </div>
</form>
